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Xanax is the brand name of a drug that includes the generic drug alprazolam as its active ingredient. Classified as a benzodiazepine, Xanax is one of the most widely used drugs on the market for anxiety disorders and panic disorders. In fact, according to Health Research Funding, Xanax is the fifth most commonly prescribed medication in the US.
The widespread availability of Xanax is troubling for a host of reasons. For instance, among individuals who abuse Xanax, average daily intake is 20-30 pills. Pharmacies are the source of these pills, not illegal drug labs (as in the case of heroin, cocaine, and methamphetamine, among other drugs). National surveys often look at Xanax abuse as part of overall prescription drug abuse, which means a precise number of users across the country is not readily available. However, it is estimated that, on average, 60,000 individuals visit an emergency room department each year as a direct result of Xanax use.
Like Xanax, Tranxene is a branded drug classified as a benzodiazepine. The generic active ingredient in Tranxene is clorazepate dipotassium. This medication is indicated for the treatment of anxiety, seizures, and withdrawal from an alcohol use disorder. Tranxene, like Xanax and other benzodiazepines, has a high risk of abuse.
Addiction to Tranxene or Xanax is unlikely in prescribed users who follow doctors’ orders of use. However, if a prescribed user takes more Tranxene or Xanax than necessary, the risk of addiction increases. Among recreational users who have no medical need for Tranxene or Xanax, there is an especially high risk of addiction, as there is no ceiling on how much of this drug may be taken nor is there an overseeing doctor to check the amount taken. It appears that there is less buzz about Tranxene abuse than Xanax abuse, which may owe to how much more the latter is prescribed in the US.
As RxList notes, benzodiazepines are often prescribed or used interchangeably under a doctor’s orders. However, Xanax and Tranxene are similar in that they are commonly prescribed to treat anxiety disorders. Tranxene, however, is included among the benzodiazepines indicated for the treatment of seizures, while Xanax is not. To add a layer of complexity to matters, from a lay standpoint, doctors are often permitted to prescribe medications “off-label” as long as the decision is based on sound medical thinking. This may then mean that Xanax and Tranxene are prescribed for conditions for which the lay public is not generally aware.
Anytime Xanax or Tranxene is prescribed, there is a possibility the medication will be abused (no one is immune from drug abuse) and a possibility that the drug will somehow be diverted to those who don’t hold prescriptions for the drug. This is the reality of prescription medications in the US today.
A main point of difference between Xanax and Tranxene relates to onset times and duration of effects. The following is a simple breakdown of these differences:
To highlight a main difference between Tranxene and Xanax, it is helpful to consider the effect that alcohol can have on these drugs. It is well established that when alcohol is taken with or after a benzodiazepine, it can cause more of the benzodiazepine to reach the brain. In other words, the effect of the benzodiazepine is heightened. By some estimates, three drinks plus a benzodiazepine (even at a low dose) can equal approximately six drinks.
Consider the window of activity of Tranxene and Xanax. Since Tranxene typically spends less time in the body, if a person waits at least 3-8 hours to drink, there may not be a hazardous interaction. However, Xanax can remain in the body for so long that the next day it may be possible for a person to drink while still having this benzodiazepine in the body.
In this way, it appears that some individuals — those who don’t take benzodiazepines and alcohol at the same time or within a short window of time — will not realize that they have consumed a dangerous combination of drugs.
The onset time of a benzodiazepine can be relevant to when withdrawal symptoms emerge. Typically, the faster acting a benzodiazepine is and the shorter its window of activity, the sooner withdrawal symptoms emerge. However, at the same time, it is necessary to bear in mind that there is no set rule for when withdrawal symptoms will develop after last use of a benzodiazepine, nor for how long withdrawal will last. However, it appears that withdrawal symptoms emerge sooner for a person who has been abusing Tranxene (because of its faster onset and shorter window of metabolism) compared to Xanax.
To illuminate the similarities between Tranxene and Xanax, it is useful to look at some of the most common withdrawal symptoms associated with each drug. The following are some of the withdrawal symptoms that have emerged in people who have stopped taking Tranxene:
The following are some of the known psychological and physical Xanax withdrawal symptoms:
Even a cursory review of each lists reveals how related the two states of withdrawal can be.
Tranxene and Xanax withdrawal have one critical characteristic in common: Withdrawal from both drugs can present numerous negative side effects, some of which can be severe. For this reason, there is a general recommendation that an individual in withdrawal from either drug undergo medical detox. During this process, the recovering individual is gradually tapered off the benzodiazepine. Tapering off helps to ensure that some of the most harmful side effects, such as seizures, do not occur. This approach avoids sending the body into benzodiazepine deprivation, after it has become accustomed to its presence.
While medical detox is most always advisable, it is never enough on its own. As the National Institute on Drug Abuse explains, detox is a necessary part of the rehab process, but it is not sufficient without follow-up care. After a person is safely weaned off Tranxene or Xanax, or their tapering schedule has stabilized, it is necessary to provide primary addiction treatment services. This stage of recovery is composed mainly of therapy (individual and group) and supportive services, such as group recovery meetings.